Evaluation of three abbreviated versions of the PTSD Checklist in Canadian Armed Forces personnel

Abstract

Introduction: Post-deployment screening within the Canadian Armed Forces (CAF) aims to identify individuals with mental health problems. However, as screening is a time-consuming process, it is important to consider ways to reduce the time required, including the use of shorter scales. The scale currently used to assess posttraumatic stress disorder (PTSD), the PTSD Checklist (PCL-C), is lengthy, although validated shorter versions have been developed that have not yet been evaluated in the CAF population. Methods: Three brief versions of the PCL-C were evaluated in this study: the PCL-2, PCL-4 and PCL-6. The operating characteristics of each scale were examined using the screening and diagnostic cut-offs of the full PCL, as well as clinician ratings of PTSD being of major concern, as the standards for comparison. Optimal cut-offs for each scale were determined based on a combination of sensitivity, specificity, area under the curve (AUC), and prevalence of disorder compared to the full scale. As well, correlations with other measures of health were examined. Results: Although all three scales demonstrated good psychometric properties, the PCL-6 showed the strongest properties of the three scales. Optimal cut-offs were similar to those found in past research when calibrated against the PCL-C screening cut-off for PTSD and to clinician ratings. As well, it exhibited high correlations with other measures of mental health. Discussion: This research provides evidence for the acceptability of brief measures in screening for PTSD in military members following deployment. In particular, it points to the advantages of using the PCL-6, with cut-offs in line with those recommended in past research.